The Purpose and Composition of F-75 Therapeutic Milk
F-75 is a carefully formulated therapeutic milk designed to address the specific and fragile physiological state of children suffering from severe acute malnutrition (SAM). During the initial stabilization phase, patients often present with complications such as infections, liver failure, or organ damage, and their bodies cannot tolerate a sudden high intake of protein, fat, and sodium. F-75 is therefore specifically balanced to support rehydration and restore metabolic functions safely.
The nutritional composition of F-75 is unique and adheres to strict guidelines set by the WHO. The liquid formula provides approximately 75 kcal per 100 ml, with a low protein (around 5% of total energy) and low fat (around 32% of total energy) content. Its high carbohydrate concentration, coming from ingredients like maltodextrin and sugar, provides energy without overwhelming the child's compromised system.
The formula is also fortified with a specific premix of vitamins and minerals. Critically, it has a very low iron content during this phase, as iron can sometimes exacerbate existing infections in the initial stages of malnutrition treatment. The key ingredients typically include:
- Milk powder
- Refined vegetable oil
- Sugar
- Maltodextrin
- Essential vitamin and mineral premix
The WHO Protocol: Phases of Malnutrition Treatment
The use of F-75 is part of a structured, multi-phase treatment protocol for SAM established by the WHO and implemented by organizations like UNICEF and Médecins Sans Frontières (MSF). This protocol ensures a gradual and safe recovery for the child.
- Phase 1: Stabilization (Inpatient)
- Goal: Restore metabolic function, treat medical complications, and correct electrolyte imbalances.
- Diet: F-75 therapeutic milk is the sole nutritional therapy. It is administered under medical supervision in a hospital setting and typically lasts between two and seven days.
- Monitoring: The child's condition, including oedema and appetite, is closely monitored during this time.
- Transition Phase (Inpatient)
- Goal: Transition the patient from the lower-calorie F-75 to a higher-energy diet.
- Diet: The child is gradually introduced to F-100 therapeutic milk or RUTF over a period of a couple of days.
- Phase 2: Rehabilitation (Inpatient or Outpatient)
- Goal: Promote rapid weight gain and catch-up growth.
- Diet: High-energy F-100 or ready-to-use therapeutic food (RUTF) is used. Once the child is stabilized and has a good appetite, they may be discharged for outpatient care with RUTF.
Comparison of Therapeutic Foods
F-75, F-100, and RUTF are distinct therapeutic foods used for different phases of malnutrition treatment. The following table highlights their key differences:
| Feature | F-75 | F-100 | RUTF |
|---|---|---|---|
| Energy Density | ~75 kcal/100ml | ~100 kcal/100ml | ~520-550 kcal/100g |
| Primary Goal | Stabilization and rehydration | Weight gain and rehabilitation | Weight gain and rehabilitation |
| Treatment Phase | Phase 1 (Initial) | Phase 2 (Rehabilitation) | Phase 2 (Rehabilitation) |
| Setting | Inpatient (hospital) | Inpatient or Outpatient | Outpatient (often home) |
| Protein Content | Low (~5% of energy) | High (~12% of energy) | High (~10-12% of energy) |
| Fat Content | Moderate (~32% of energy) | High (~53% of energy) | High (~45-60% of energy) |
| Preparation | Powder mixed with water | Powder mixed with water | Ready-to-use paste |
| Hygiene Requirement | Critical due to reconstitution | Critical due to reconstitution | Reduced risk as ready-to-use |
Preparing and Administering F-75
Proper preparation and administration of F-75 are critical for its effectiveness and the patient's safety. The formula typically comes as a powder in a canister and must be mixed with the specified quantity of clean, boiled, and cooled water. Given the risk of infection in severely malnourished children, strict hygiene standards must be maintained. For this reason, F-75 is restricted to therapeutic feeding centers and is not distributed for home use. Once prepared, the formula should be used immediately, and any remaining liquid should be discarded after a specific period to prevent bacterial contamination.
The Critical Role of F-75 in Humanitarian Efforts
For many years, humanitarian aid organizations have relied on the WHO protocol involving F-75 to combat child malnutrition in crisis-affected areas. The protocol has been instrumental in reducing the mortality rate of severely malnourished children by providing a safe and effective initial treatment. By stabilizing the most fragile patients first, health personnel can address underlying infections and metabolic issues, paving the way for recovery. The targeted nutritional delivery of F-75 prevents refeeding syndrome, a dangerous condition that can occur when severely starved individuals are given aggressive refeeding too quickly.
This precise approach ensures that limited resources are used effectively to save the lives of the most vulnerable children, especially those aged 6 months and older who are most at risk. It is a cornerstone of modern emergency nutrition and a testament to how specialized nutritional science can be applied to achieve significant public health outcomes.
Conclusion
In the realm of emergency nutrition and public health, F-75 is a specialized and indispensable therapeutic diet for the initial treatment of severe acute malnutrition. It serves as a metabolic 'reset' button, allowing the most critically ill patients to stabilize and recover before moving on to the weight gain phase of their treatment. Developed under strict WHO guidelines, its low-protein, low-fat, and carbohydrate-rich composition is precisely tailored to prevent further harm and safely prepare a child's body for recovery. Its use is limited to supervised clinical settings, underscoring its medical-grade nature. The success of F-75 and the multi-phase WHO protocol has transformed the approach to managing SAM, making it a critical tool in the fight against childhood malnutrition worldwide.
More information on malnutrition treatment:
For further reading on the management of severe malnutrition, including the full guidelines on F-75 and F-100, refer to the World Health Organization's official manual: Management of severe malnutrition: a manual for physicians and other senior health workers.
